Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results...

20
(ASX: IMM, NASDAQ: IMMP) Immutep AIPAC Phase IIb Clinical Results & Update Global Webcast Slides Date & Time: Thursday, March 26th, 8am Australian Eastern Daylight Time / Wednesday, March 25th, 5pm US Eastern Daylight Time Following the event a replay of the webcast will be made available via http://public.viavid.com/index.php?id=138665 A replay of the webcast will also be made available at www.immutep.com from the day after the event.

Transcript of Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results...

Page 1: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

(ASX: IMM, NASDAQ: IMMP)

Immutep AIPAC Phase IIb Clinical Results & Update Global Webcast Slides

Date & Time: Thursday, March 26th, 8am Australian Eastern Daylight Time / Wednesday, March 25th, 5pm US Eastern Daylight Time

Following the event a replay of the webcast will be made available via http://public.viavid.com/index.php?id=138665

A replay of the webcast will also be made available at www.immutep.com from the day after the event.

Page 2: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

2

The purpose of the presentation is to provide an update of the business of Immutep Limited ACN 009 237 889 (ASX:IMM;

NASDAQ:IMMP). These slides have been prepared as a presentation aid only and the information they contain may require

further explanation and/or clarification. Accordingly, these slides and the information they contain should be read in conjunction

with past and future announcements made by Immutep and should not be relied upon as an independent source of information.

Please refer to the Company's website and/or the Company’s filings to the ASX and SEC for further information.

The views expressed in this presentation contain information derived from publicly available sources that have not been

independently verified. No representation or warranty is made as to the accuracy, completeness or reliability of the information.

Any forward looking statements in this presentation have been prepared on the basis of a number of assumptions which may

prove incorrect and the current intentions, plans, expectations and beliefs about future events are subject to risks, uncertainties

and other factors, many of which are outside Immutep’s control. Important factors that could cause actual results to differ

materially from assumptions or expectations expressed or implied in this presentation include known and unknown

risks. Because actual results could differ materially to assumptions made and Immutep’s current intentions, plans, expectations

and beliefs about the future, you are urged to view all forward looking statements contained in this presentation with caution.

Additionally, the INSIGHT investigator sponsored clinical trial described in this presentation is controlled by the lead investigator

and therefore Immutep has no control over this clinical trial. This presentation should not be relied on as a recommendation or

forecast by Immutep. Nothing in this presentation should be construed as either an offer to sell or a solicitation of an offer to buy

or sell shares in any jurisdiction.

Notice: Forward Looking Statements

Page 3: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

Eftilagimod Alpha

(efti or IMP321)

Page 4: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

4

APC Activator

IMMUNOSTIMULATION IMMUNOSUPPRESSION

APC

MHCII

Efti

LAG-3

T Cell

T Cell

IMP761

Immuno-oncology

Combination Therapies

Viral Infections

Rheumatoid

Arthritis

IBD Multiple

Sclerosis

LAG-3

Targeting LAG-3 / MHC II may lead to multipletherapeutics in numerous indications

Partnered with

GSK’781

LAG525

AgonisticmAb

DepletingmAb

AntagonisticmAb

Partnered with

Page 5: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

5

Immutep Controlled Immunotherapy Pipeline (Oncology)*

Program Preclinical Phase I Phase II Late Stage(4) Commercial

Rights

Eftilagimod

Alpha

(efti or IMP321)

APC activating

soluble LAG-3

protein

On

co

log

y

Non-Small-Cell Lung Carcinoma (IO – IO) (1)

TACTI-002

Head and Neck Squamous Cell Carcinoma (IO – IO) (1)

TACTI-002

Solid Tumors (IO – IO) (2), (3)

INSIGHT-004

Melanoma (IO – IO)

TACTI-mel

Solid Tumors (In situ Immunization) (2)

INSIGHT

Metastatic Breast Cancer (Chemo – IO)

AIPAC

Global Rights

Notes

* Information in pipeline chart current as at 19 March 2020

(1) In combination with KEYTRUDA® (pembrolizumab) in non-small cell lung carcinoma (“NSCLC”) or head and neck carcinoma (“HNSCC”)

(2) INSIGHT Investigator Initiated Trial (“IIT”) is controlled by lead investigator and therefore Immutep has no control over this clinical trial

(3) In combination with BAVENCIO® (avelumab)

(4) Late stage refers to Phase IIb clinical trials or more clinically advanced clinical trials

Metastatic Breast Cancer (Chemo – IO)Chinese Rights

Page 6: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

6

Efti: a Pipeline in a Product

✓ First-in-Class MHCII agonist

✓ good safety profile

✓ unique protective IP positioning (unlike

ICI mAbs)

✓ encouraging efficacy data

✓ low cost of goods

✓ potential for use in various

combination settings ->

efti is a “pipeline in a product”

Cancer antigen

presentation

(dentritic cells/APCs)

Trafficking of T cells to

tumors (CTLs)

Infiltration of T cells

into tumors

(CTLs, endothelial cells)

Recognition of cancer

cells by T cells

(CTLs, cancer cells)

Killing of cancer

cells (Immune and

cancer cells)

Release of cancer

cell antigens

(cancer cell death)

Priming and activation

(APCs & T cells)

1

2

3

4

5

6

7 PD-1/PD-L1Chemotherapy

Efti (APC activator)

Efti (APC activator)

Efti has disruptive potential for oncology

Page 7: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

AIPAC Update

Page 8: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

8

Efti positioning in HR+/HER2- MBC

Epidemiology:

• 812,500 HR+/HER2- diagnoses per annum worldwide(1)

• approximately 250,000 develop metastatic disease and are eligible to receive chemotherapy

MBC – metastatic breast cancer BC – breast Cancer

Notes

(1) Source: GlobalData 2019

Current Status:

• despite all changes for early treatment lines → no

improvement for patients receiving first-line

chemotherapy

• taxane monotherapy widely used in first-line

chemotherapy setting

• no active IO approved / or in late-stage trials

Typical Patient Population in MBC:

• number of pre-treatments have increased over recent years → patients

receive chemo at a later stage → shortened expected benefit

• expected that most patients starting with chemotherapy have:

• visceral disease

• usually 1 or 2 previous anti-cancer therapies

Endocrine therapy+/- CD4/6 inhibitors

Diagnosis of metastatic disease

Start of chemotherapy

Weekly paclitaxelSOC in the EU Chemo 2 Chemo 3Endocrine therapy

+/- CD4/6 inhibitors

~25%

~35%

~40%

Page 9: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

9Notes:

ORR – overall response rate, DCR – disease control rate, PFS – progression free survival, OS – overall survival, QoL – Quality of life

AIPAC: Active Immunotherapy PAClitaxel in HER2-/ HR+ metastatic breast cancer (MBC)

Fact sheet

✓ Conducted in 7 EU countries

✓ Local and blinded independent central read

✓ LPI enrolled Jun 2019

✓ Cut-off for primary analysis 10th Jan 2020

(Data received 24th Mar 2020)

o OS data expected by end of 2020

Efti: Clinical DevelopmentAIPAC (Phase IIb)

Primary endpoint includes:

• Assessment of Progression-Free Survival (PFS)

including confidence intervals (note: no hypothesis

testing), and,

• Hazard Ratio: relative risk of progression compared to

placebo;

Secondary endpoints include:

• Overall Response rate (ORR) and Overall Survival (OS)

• Biomarker and Immune Monitoring

• Safety and tolerability

Arm 1 - 114 patients:paclitaxel + efti for 6 months + eftimonotherapy thereafter

Phase IIb, multinational,

randomised, double-blind

Arm 2 - 112 patients:paclitaxel + placebo for 6 months + placebo monotherapy thereafter

Primary endpoints: PFS

Secondary endpoints: OS,

safety, ORR, QoL

Patients with late stage

HR+/HER2- MBC

Page 10: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

10

AIPAC Phase IIb Clinical Results

Baseline Characteristics

• Well balanced treatment groups• Very late stage disease and large proportion pre-treated with CDK4/6

Paclitaxel + EftiN=114

Paclitaxel + Placebo N=112

Median age (range) 58 yrs (24-87) 61 yrs (35-79)

ECOG 0 60.5 % 62.5 %

% visceral disease 90.4 % 92.9 %

% pre-treated with CDK4/6 for met disease 43.9 % 42.9 %

One or more systemic therapies for metastatic disease 68.4 % 71.4 %

Tumor type (central pathology)Luminal ALuminal B

34.1 %*48.8 %*

36.7%*49.4%*

Monocytes at baseline < 0.25 x 109/L 21.9 % 19.8 %

* Reference number of patients different as not all patients were assessed centrally

Page 11: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

11

AIPAC Phase IIb Clinical Results

Effect on PFS as long as paclitaxel is given together with efti

Chemo-immuno

Investigator ReadBlinded independent investigator read (BICR)

PFS estimates – primary analysis*BICR

Paclitaxel + EftiN=114

Paclitaxel + Placebo N=112

HR [95 % CI ]

Median in months [95 % CI ]Mean in months [SE]% progression free at 6 months

0.93 [0.67-1.30], p=0.341

7.29 [6.64-7.46]7.12 [0.37]

63 % [52%-71%]

7.29 [5.52-7.46]6.64 [0.38]

54 % [43%-63%]

PFS estimates – primary analysis*Investigator Read

Paclitaxel + EftiN=114

Paclitaxel + Placebo N=112

HR [95 % CI ]

Median in months [95 % CI ]Mean in months [SE]% progression free at 6 months

0.92 [0.69-1.23], p=0.305

7.16 [5.65-7.39]6.81 [0.33]

57 % [47%-66%]

6.70 [5.52-7.33]6.30 [0.31]

54 % [43%-63%]

Chemo-immuno

Page 12: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

12

AIPAC Phase IIb Clinical ResultsSubgroup 1 – low monocytes - PFS

• Low monocyte counts (i.e. compromised innate immunity) fit with mechanism of action of efti and are very

interesting for other studies e.g. TACTI-002

• Differences in subgroups confirmed both by BICR and investigator read

Progression free survival estimates per subgroup

Paclitaxel + EftiMedian, months

Paclitaxel + PlaceboMedian in months

Hazard Ratio [95 CI]; p-value

low (<0.25 x 109/L) monocytes at baseline BICRInvestigator Read

7.297.46

5.455.16

0.61 [ 0.29-1.15]; p=0.0840.44 [0.21-0.90]; p=0.012

Page 13: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

13

AIPAC Phase IIb Clinical ResultsSubgroup 2 – luminal B - PFS

• Luminal B (more aggressive tumor growth subtype): an interesting observation indicating that fast growing tumors

(e.g. NSCLC in TACTI-002) are better targets for APC activators like efti

• Differences in subgroups confirmed both by BICR and investigator read

Progression free survival estimates per subgroup

Paclitaxel + EftiMedian, months

Paclitaxel + PlaceboMedian in months

Hazard Ratio [95 CI]; p-value

luminal B typeBICRInvestigator Read

7.297.20

5.455.55

0.65 [0.38-1.11]; p=0.0580.72 [0.45-1.15]; p=0.081

Page 14: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

14

AIPAC Phase IIb Clinical ResultsSubgroups – summary - PFS

• Luminal B and low monocyte count sub-groups fit well with mechanism of action of efti and are very interesting for

other studies e.g. TACTI-002

• Differences in subgroups confirmed by BICR and investigator read

• Further analysis (Cox model) will be carried out

Compelling results observed in multiple patient subgroup populations

Progression free survival estimates per subgroup

Paclitaxel + EftiMedian, months

Paclitaxel + PlaceboMedian in months

Hazard Ratio [95 CI]; p-value

lower performance status at baseline BICRInvestigator Read

7.136.64

6.675.52

0.76 [0.43-1.35]; p=0.1780.67 [0.42-1.09]; p=0.057

• Meaningful differences in different subgroups (Note: phase II studies are not powered to show statistical

significance for subgroups!)

• Besides the two subgroups and the low ECOG performance status (see details below) there are more

interesting subgroups like age, BMI etc.

Page 15: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

15

AIPAC Phase IIb Clinical Results

Efficacy improvement observed from efti compared to placebo in terms of ORR

• In efti group higher response

rate and fewer pts with

immediate progression

• Response rate (38.4 %) of

placebo group is relatively

high compared to historical

data

• Disease Control Rate (85.1

%) and Response rate (48.3

%) in efti group is consistent

with previously reported data

• Combination therapy was

safe & well tolerated

BOR acc. to RECIST 1.1 by BICR Paclitaxel + EftiN=114

Paclitaxel + PlaceboN=112

Complete Response 0.9 % 1.8 %

Partial response 47.4 % 36.6 %

Stable disease 36.8 % 37.5 %

Progressive Disease 8.8 % 18.8 %

Non-evaluable 6.1 % 5.4%

Overall Response Rate 48.3% 38.4%

Disease Control Rate 85.1 % 75.9%

Page 16: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

16

AIPAC Phase IIb Clinical Results

Conclusions

• Combination therapy was safe and well tolerated

• In efti group higher response rate and fewer patients with immediate

progression

• In the first months together with paclitaxel, improvement of delay in

progression

• Interesting subgroups (low monocyte count, luminal B, etc.) to be

investigated further

• Immutep will pursue regulatory interaction to outline next steps in MBC

Page 17: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

Outlook

Page 18: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

18

Update on Other Ongoing Efti Studies

TACTI-002 Phase II Study

• 74 patients enrolled at 12 sites in AU, ES, UK and US

• ORR in HNSCC and 1st line NSCLC highly encouraging compared to pembrolizumab monotherapy

• Further data expected in the course of 2020

• Recruitment progressing well

Study – Part* Stage 1 (N)Actual/target

Stage 2 (N)target

Part A - 1st line NSCLC

17/17 16/19

Part B - 2nd line NSCLC

17/23 -/13

Part C - 2nd line met. HNSCC

18/18 6/19

AIPAC-002

• IND approved & open for FDA interaction in MBC

• Planning continuing pending further analysis of AIPAC

INSIGHT-004

• Cohort 1 - fully recruited

• Cohort 2 - 2/6 pts recruited

TACTI-mel

• CSR in preparation

COVID update: TACTI-mel & AIPAC not affected as data already monitored, recruitment for TACTI-002 continues →monitoring strategy is under discussion with CRO → limited impact on Immutep’s clinical activities

Page 19: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

19

2020 Outlook*

Upcoming news 2020 (est):

• Further AIPAC data e.g. OS

• NSCLC 1st line - more data from Stages 1 and 2 from TACTI-002 throughout 2020

• HNSCC 2nd line - initial data from Stages 1 and 2 from TACTI-002 throughout 2020

• NSCLC 2nd line - initial data from Stage 1 from TACTI-002 throughout 2020

• Combination with avelumab - initial data from Phase I trial throughout 2020

• Regulatory progress

• Update from partnered programs with GSK and Novartis

• Updates from efti partnerships

• IMP761 updates

*The actual timing of future data readouts may differ from expected timing shown above. These dates are provided on a calendar year basis.

Page 20: Immutep AIPAC Phase IIb Clinical Results & Update Global ......AIPAC Phase IIb Clinical Results Baseline Characteristics • Well balanced treatment groups • Very late stage disease

Thank you!